Plné znění - 241/2006 Sb.

Xxxxxxxxxxxxx xxx xxx Assessment xx Xxxxxxxxxxxx xxx xxx Xxxxxxxxx of Xxxxxxxxx Support xx Xxxxxxx of Xxxxxxxx Xxxx xxxxxxxx xx Xxx No. 209/1997 Xxxx., xx the xxxxxxxxx xx fulancial xxxxxxx xx xxx xxxxxxx xx xxxxxxxx xxxx xxx xx xxxxxxxx xxxxxxx other xxxx, xx amended

Dear Xxx/Xxxxx,

Xx xxxxxxxxx xxx xxxxxxxxx xxx with xxxxxxxx xxxxxxxxx xx xxxx current situation. Xxxxxxx, xxxxxxx in xxxx questionnaire xx xxxxxxxx for the xxxxx xxxxxxxxxx xx xxxx application for xxx provision of xxxxxxxxx xxxxxxx xxxxxxxx xx Act no. 209/1997. Xxxxx xxx xxx xxxx xxxxxxxxxxx; xx xx xxxxxx xxxxxxxxxxx.

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X. Xxxxxx xxxxxxx xxxx xx xxx xxxxxxxx data of xxx xxxxxxxxx - x.x. the xxxxxx xx xxx xxxxxxxx xxx who xxx xxxxxxxx xxxxxx harm, xx xxx survivor xx x xxxxxx xxx xxx xxxx xx consequence of xxx xxxxxxxx act:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Xxxx xx xxxxx:

4. Xxxxxxxxx xxxxxxx:

5. Xxxx xxxxxxxx address (xxxxxx xx xxxxxx xxxx xxx permanent address, xxxx):

6. Phone Xxxxxx:

7. X-xxxx xxxxxxx:

8. Xxxxxxxxxxx:

XX. Xx xxx xxxxxxxxx xx represented xx xxxxxxx xxxxxx ("xxxxxxxxxxxxxx") xx xxx xxxxx xx xxxxxxxxx representation (xxx xxxxxxxx, a xxxxx xxxxx xxxxxxxxxxx xx his/her xxxxxx) xx on the xxxxx of x xxxxx xx xxxxxxxx, xxxxxx xxxx xx xxx data of xxxx xxxxxxxxxxxxxx:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Xxxxxxxxx xx registered address:

If xxx xxxxxxxxxxxxxx xx xxxxxx the application xx xxxxxx of xxx xxxxxxxxx, xxxxxx xxxx xxxxxx a xxxxxxxx xxxxxxxxxxx xxx/xxx xx xxxxxxxxx xxx xxxxxxxxx - a xxxx xx x xxxxx xx xxxxxxxx (xxx contractual xxxxxxxxxxxxxx) xx x xxxx xx xxx xxxxx xxxxxxxxxxx (xxx statutory xxxxxxxxxxxxxx) xx xxx xxxxx xxxxxxxxxx xxxxxxxx.

XXX. Xx xxx applicant xx x survivor xx a xxxxxx xxx xxx xxxx xx xxxxxxxxxxx xx xxx xxxxxxxxxx xxxxxxxx xxx, xxxxxx xxxx xx xxx xxxxxxxx xxxx xx xxx xxxxxxxx:

1. Surname:

2. Xxxxx xxxx:

3. Xxxx of xxxxx:

4. Date of xxxxx:

5. Xxxx permanent xxxxxxx:

6. Xxxxxxxxxxx:

7. Relationship xx xxx deceased xx xxx xxxxxxxxx (x.x. xxxxxx, xxxxxxxx, xx xxxxxxxxxx living xx xxxxxx xxxxxxxxx)

Xx xxx xxxxxxxxx xx x xxxxxxxx xx x xxxxxx xxx xxxx xx consequence xx xxx xxxxxxxx xxx, xxxxxx attach x xxxx of xxx xxxxx xxxxxxxxxxx xxx xxx xxxxxxxxx xxxxxxx xxxx xxx xxxxxxxx xxxxxxxxx xx xxx an xxxxxxxxxx xx support the xxxxxxxx (xx xxx xxxx of x xxxxxx-xxxxx xxxxxxxxxxxx, xxxx xxxxxxxxx xxxxxxx xxxxx xxxxxxxxxxxx xx a xxxxx decision xx xxx xxxxxxxxxx xx xxxxxxx the xxxxxxxxx; xx the xxxx xx xxxxxxx xxxxxxx, xxxxxx xxxxxx x xxxxxxxx xxxxxxxxxxx).

Xxxxxx xxxxxxx xxx xxxx xx which xxx xxxxx xxx xxxxxxxxx xxx, xx xxx xxxxxx learned xxxxx the xxxxxxxxxxxx xx xxx xxxxx xx x xxxxx xxxx, please also xxxxxxx xxx date xxx the manner xx xxxxx xxx xxxxxx learned of xxxx xxxxxxxxxxxx (x.x., xxx xxxx of xxx medical xxxxxx).

XX. Xxxxxx xxxxxxx xxx xxxxxxxx xxxxxxx xxxxxxxxx (x.x. xxxxxx, xxxxxx xxxxxxxxxx'x xxxxxx, court) xxxxx xxxx recently xxxxxxxxx criminal xxxxxxxxxxx. Xxxxx xxx xxxxxxxxx xxxxxx xx xxx xxxx related xx xxx xxxxxxxxxx xxxxxxxxxxx.

Xx xxxxxxxxx, please xxxxxx xxx latest decision xx xxx xxxxxxxxxxxxxx xxxxxxxx xxxxxxx authority xxxxx xxxxx xxxxxxxx xxx xxxxx xx xxx xxxxxxxxxx xxxxxxxxxxx (x.x. resolution xx xxx discontinuation of xxxxxxxx xxxxxxxxxxx, xxxx xx xxx xxxxxxxxxx, xxxxxxxxx - final xx otherwise).

Xxxxxxxxx xx xxx xxxxxxxxxx xx §8 of Xxx xx. 209/1997, xxx xxxxxx xx xxxxxxxxx support may xx reduced or xxxxxxxx xxxxxxxxx xx xxxxxxx xxx victim xxx xxxx xxx xx xxx xxxxx xxxxxxxx xx enforce x xxxxx for xxxxxxxxxxxx xxxxxxx the xxxxxxxx xx xxx xxxxx xxxxxx xxxxxxxxxxx xxx the harm xxxxxxxx. Xx xxx xxxx xx xxxx xxxx xx the xxxxxxxx xxx xxx xxxx identified.

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Fill xx xxxx XxXx if xxx xxxxxxxxx xx x xxxxxxxx of xx xxxxxxxxxx who xxx died in xxxxxxxxxxx xx xxx xxxxxxxxx crime.

1. Xxx xxx x xxxxx, xxxxxx xx xxxxx xx xxx xxxxxx who xxxx xx xxxxxxxxxxx xx xxx xxxxxxxx xxxxxxx?

2. Xxx xxx xxxx xx a common xxxxxxxxx xxxx xxx xxxxxxxx xxxxxx xxxxx xx xxx xxxxxxxxxx xx xxx xxxxx?

3. Xxxx you a xxxxxxxxx of the xxxxxx xx was xxx xxxxxxxx xxxxxxx xx support xxx?

4. Xx xxx xxxxx xxxxxxx xxxx xxx xxxxxxxxxx xxxxxxxxx xx xxxxxxx 1 xx 3? Please xxxx xxxxx xxxxxx, xx xxxxx xx you.

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According xx xxx xxxxxxxxxx xx §2, section 2 of Act xx. 209/1997, a xxxxxx xxx xx x survivor xx x xxxxxx who xxxx in xxxxxxxxxxx xx a criminal xxx xx xxxxxxxxxx xx be a xxxxxx if xx xx she is x xxxxxx, spouse xx xxxxx xx xxx xxxxxxxx and xxxxx xxxx xxx xx xxx xx xxx xxxx household xx if xxx xxxxxx was x xxxxxxxxx of the xxxxxxxx xx the xxxxxxxx was xxxxxxxx xx xxxxxxx the xxxxxx.

Xx the xxxxxxxxx xx xxx victim xx x xxxxx xxx xxx xxxxxxxx xxxxxx xxxx, xxxxxx xxxx xx xxxxx XX - XXX.

Please attach x xxxxx-xxxxx assessment xx xxxx and xxxxxxxxx xxxxxxxx to Xxxxxx Xx. 440/2001 Xxxx. The respective xxxxxxxx xxxxxx be xxxxxxxx xxxx xxx xxxxxxxxx responsible for xxx victim's xxxxxxxxx. Xxxx medical xxxxxx xxxx xxxxxxx x xxxxx-xxxxx assessment xx xxx xxx xxxxxxxx xxx x xxxxx-xxxxx xxxxxxxxxx xx xxx xxxxxxxx xx xxx xxxxxx'x xxxxxx position. Xxxxxx xxxx in xxxx xxxx xxxx xxx point-based xxxxxxxxxx xx xxx pam xxxxxxxx xx xxxxxxxx xxx the xxxxxxxx xx Act xx. 209/1997. According to xxx provisions xx §6, xxxxxxx 2 xx Xxx no. 209/1997, no financial xxxxxxx xxxx be xxxxxxxx xxxxxx the xxxxx xxxxxxxxxx xx xxx xxxx xxxxxxxx xx xx xxxxx 100 xxxxxx.

The xxxxxx xxx xxxxxx xxxx sum xxxxxxxxx xxxxxxx xx the xxxxxx of XXX 25,000 or xx xxxxxx equal to xxx xxxxxx xxxxx xx xxxxxxx treatment xxx xxxx xxxxxx (§7, xxxxxxx 1, xxxxxx x xx Xxx Xx. 209/1997 Xxxx.). lf xxx xxxxxx xx xxxxx xxx a xxxx xxx xxxxxxx, xxxxx xx xx need xx xxxx in xxxxx XII - XxX.

Xxxx includes xxx xxxxxxxx xxx xxxxxxxxxx, xxxxxxxx equipment, xxxxxxxxxxxxxx xxxxx, xxxxxx xx assistant to xxxx xxx xx xxx xxxx xx xxxx xxxxxxx xxxxxxxxx, xxxxxxxxx xxxxxxxxxxxxxx xxxxx xxx., xxxxxxxx such xxxxx xxxx xxx xxxx xxxx xx xx xxxxxxxxx company. xx xxxx xxxxxxxx xxx xxx xxxxxx xx documentary xxxxxxxx, xxx Xxxxxxxx xx Xxxxxxx xxx xxx xxxx xxxx xxxx xxxxxxxxxxxxx.

Xxxxxx xxxxxx xxx xxxxxxxxx xxxxxxxxxx xxxx facts to xxx application.

If the xxxxxxxxx is xx xxxxxxxx, xxxxx xxxxxxxxx xxxxx xxxxxxx x xxxxxxxxx xxxx his/her xxxxxxxx describing the xxxxxxx salary xxxxxxxxx xx §351 et. xxx. xx Xxx xx. 262/2006, the Xxxxx Labour Xxxx, xx xxxxxxx. xx xxx xxxxxxxxx xx xxxx-xxxxxxxx, xxxx document xxxxx xx a xxxx xx his/her xxxx xxxxxx xxx xxxxxx. xx xxx xxxxxxxxx xx x xxxxxxx xxxxxx xxx xx xxxx to xxxxx xxx/xxx xxxxxxxx xxxxxx xxxxxxxx, xxxxxx xxxxxx x xxxxxxxx xxxxxxxxxx xxx amount xx xxx xxxxxxxxxx xxxxxxx. xx xxx xxx xxxxxx xxx xxxxxxxxx'x income xxxxxxxxx xxxxxx xx proven, xx xxxxxxxxxxx xxxxx xx affidavit xxx xx attached.

Xx xxxxxx standing has xxxx xxxxxxxx xx x xxxxxx of xxx xxxxxxxx act xx xxxxx I xxx x xxxxxx. X xxxx xxx xxx been compensated xxx xxx xxxx 1 have xxxxxxxx xx a result xx xxx xxxxxxxx xxx.

X xxxxxx xxxxxx xxxx I xxxx xxx xxxxxx xxx xxxxx xxx xxxxxxxxx xxxxxxx xx xxx xxxxxxx xxxxx xxx xxxxxxxxxxxx for xxx xxxx xxxxxxxx xx x result xx xxx criminal xxx xx xxx country xxxxx than the Xxxxx Republic.

I xxxxxxxxxxx xxxx according to §12 of Xxx Xx. 209/1997 Xxxx., xx xxx xxxxxxxxx xx xxxxxxxxx support xxx the victims xx criminal xxxx xxx on amending xxxxxxx xxxxx xxxx, xx xxxxxxx, X xx obliged xx xxxxxxxxx xxx Ministry xx Xxxxxxx any xxxxxx xxxxxxxx xx xxxxxxxxxxxx xxx xxx xxxx xxxxxxxx, xx xx xxx amount xx xxx financial xxxxxxx, within xxxx xxxxx xxxx xxx xxxx of xxxxxxxxx xxx xxxxxxx xxxxxxx. X also xxxxxxxxxxx xxxx, after the xxxxx xx the xxxx-xxxx xxxxxx, I xxx xxxx xx xxxxxxxxxxx asking xxx Xxxxxxxx xx Xxxxxxx xx waive xxx xxxxx'x xxxxx xxx xxx xxxxxx xx xxx xxxxxxxx xxxxxxx, xxxxxx xxxx x xxxxxx xx xxxx xxxxxxxx xx xx xxxxxx standing, the xxxxx xxxxxx of xxxx xxxxxxxx xxx xxx xxxxxx xx xxxxxxxxxxxx received.

I xxxx xxxxxxxxxxx xxxx consciously xxxxxx xxxxx xx xxxxxxxxxx xxxxxxxxxxx xx xxxxxxxxxxx xxxxxxxxxxx xxx xxx xxxxxxxx xx xxxxxxxxxxxxx gaining xxxxxxxx xxx xxxxxxxxx xx xxxxxxx xxxxxxxx to §21, section 1, xxxxxx x) xx Xxx xx. 200/1990 Xxxx., xx offences xx xxxxxxx.

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Xxxxxxxxx xx xxx xxxxxxxxx xx xxx/xxx representative

- Upon xxxxxxx of xxx xxxxxxxxxxx xxx xxx xxxxxxxxx xx financial xxxxxxx xxxxxxxx xx Xxx Xx. 209/1997, xxx Ministry xx Xxxxxxx shall confirm xxxxxxx xxx xxxxxx xx a serial xxxxxx. Xxxxxxxxxxxx, xxx Xxxxxxxx xxxxx xxxxxxxx xx investigation xxxx xxx xxxxxx xx x xxxxxxx xxxxxxxxx xx per the xxxxxxxx details xx xxx xxxx. Xxxxxx xxxxx months from xxx xxxx xx xxx xxxxxxx of xxx xxxxxxxxxxx xxx xxxxxxxxxx xx xxx xxxxxxxxx documents, xxx Xxxxxxxx xxxxx xxxxxx xxxxxxx xxx xxxxxxx xx xxxxxx xxx xxxxxxxxx xx the xxxxxxx why xxxx xxxxxxx has been xxxxxxxx.

- Xxx xxxxxxxxx xxxxx xx considered x xxxxxx as xxx Act No. 209/1997 Coll. xxxx xx xx/xxx xxx xxxxxxxx xxxxxx harm xx x xxxxxx xx xxx commitment xx x crime. X xxxxxxxxx xxx xxx xxx ohly xxxxxxxxx for xxx xxxxxx'x xxxxxxx of xxxxxxxx xxxxxxx shall xx the xxxxxx xx xxx point-based xxxxxxxxxx xx xxx xxx xxxxxxxx (xxx xxx xxxxxxxxx xx xxxxxx xxxxxxxx), which xxxx xx xx xxxxx 100 points. Xxxxxxxxx xx x xxxxxx who xxx xxxx xx xxxxxxxxxxx xx a xxxxx xxxxx be xxxxxxxxxx xx xx x xxxxxx xx xxx xxxxxxxx xx a xxxxxx, xxxxxx xx xxxxx xx the xxxxxxxx xxx xxx xxxxxxxx xxxxxx x xxxxxxxxx xxxx the xxxxxxxx xx the xxxx xx xxx/xxx xxxxx xx if xxx xxxxxxxx xxxxxxxxx xx xxx required xx xxxxxxx xxx xxxxxxxx.

- Xxx Xx. 209/1997 Xxxx. xx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xx xxxxxxx xx xxxxxxxx xxxx stipulates a xxxxxxxxxx xxxx xx 1 xxxx from xxx date xx xxxxx xxx xxxxxx xxxxxxx of xxx xxxx xxxxxx xx xxx xxxxx. Xx xxxx xxxx xxxx xxx coincide xxxx xxx xxxx xx xxx xxxxxxxxxx xx xxx xxxxx, xxx xxxxxx xxxxx provide xxxxxxxx xx xxx xxxx xx which xx/xxx learned of xxx xxxxxxxxxxxx. Xxx Xxxxxxxx xx Justice xxxxxx xxxx an xxxxxxxxxxx xxx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxxxxxxx xxxxxxx xxxxx xxx lapse xx xxx abovementioned xxxxxx.

- Xxxxxxxxx xxxxxxx xx xxxxxxx for xx a xxxxxx xxx has xxxxxxxx xxxxxx xxxx xx x result xx xxx xxxxxxxxxx xx x crime xxx xx xx xxx xxxx of a xxxx sum xxxxxxxxx xx XXX 25,000 xx xx xxxxxx xxxxx to xxxx xxxxxx or xxx xxxxx of xxxxxxx xxxxxxxxx xx xxxxxx xx the xxxxxx, xxxxxxx by xxx xxxxxx previously xxxx xx xxx xxxxxx xx xxxxxxxxxxxx for xxx xxxx xxxxxxxx. Xxx xxxxx amount xx xxxx support xxxx xxx exceed XXX 150,000. If, xxxxx xxx xxxxxxxxx xx xxxxxxx, xxx xxxxxx xxxxxx xxxx xxx xxxx xxxxxxxx xxxxxxx the amount xxxxxxxx, xxx victim xxx xxxxxxx xxxxxxxxxx xxxxxxx up to xxx amount xx XXX 150,000 if xx/xxx xxxxxxx for xx xxxxxx xxx xxxxxxxxxxxxxx period of xxxx (i.e., 1 xxxx xxxx xxx xxxx xx which xxx xxxxxx xxxxxxx xx xxx xxxx xxxxxx xx xxx xxxxx); xx xxxx xxxx, any amounts xxxxxxx paid xxxx xx xxxxx xxxx xxxxxxx.

- An xxxxxxxxxx xxx xx x xxxxxxxx of x xxxxxx xxx xxx xxxx as a xxxxxx xx xxx xxxxxxxxxx xx x xxxxx (x xxxxxx, xxxxxx xx xxxxx xx xxx deceased xxxxxx xx x xxxxxx xxxxxxxxx with xxx deceased xx xxx time of xxx/xxx xxxxx or xxxxxxxxx xx xx xxxxxxxx xx xx xxxxxxxxx xx xxx xxxxxxxx) shall be xxxxxxxx xxxx x xxxx xxx xxxxxxxxx xx CZK 150,000. Xxx xxxxx amount xxxxxxxx xx xxxxxxxxx xxxxxxx xxxxx xxx xxxxxx XXX 450,000; xxxxxx the number xx victims xxxxxx xxxxx, xxx xxxxxx xxxxxxxx xxx victim xxxxx xx xxxxxxx xxxxxxxxxxx.

- Xxx Xx. 209/1997 Coll. xxxx xxx replace the xxxxxxxxx xx the xxxxxxxxx xxxxxxxxx xx xxxxxxxxx xx motor xxxxxxxx related to xxxxxxxxxx liability xxxxxxxxx. Xx xxxxxxx xxxxxxx xx xxxxxxx xxxxxxxxx, xxxxxxxxxxxx xxx insurance xxxxxxxx xxxxxx xxxx xx xxxxxxxx xx xxx insurers xxxxxxxxx xxxx xxxxxxxxx xxxxxxxxx. Xxxx in isolated xxxxx, xx xxxx xx exceptional xxxxxxxxxxxxx, xxx xx application xxx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xx filed with xxx Xxxxxxxx xx Xxxxxxx.

- Xxxxxx xxxx xx xxxx that xxx available xxxxxxxxx xxx xxxxxxxxxxxxx required xxx xxx xxxxxxxxxx xxxxx xxxx xx xxxxxxxx xx xxx xxxxxxxxxxx. If xxx xxxxxxxxx fails xx xx so, the Xxxxxxxx of Xxxxxxx xxxxxx properly process xxx xxxxxxxxxxx. Should xxx xxxxxxxxx fail xx xxxxxxx xxx xxxx xxxxxxxxx xxx xxxxxxxxxxxxx xxxx xxxxxx x xxxxxxxxxxxxx deadline, xxxx xxxx may xxxxxxx x xxxxxxxx xx withhold xxx xxxxxxx xx xxx Xxx Xx. 209/1997 Xxxx. Xxxx shall xxx, xxxxxxx, xxxxxxxxx xxx xxxxxx xx xxxxxxx xxxxxxxxxxx.

- Xxxxxx xxxx xx mind xxxx xxx xxxxxxxxx xxxxx xx obliged xx return any xxxxxxxxx xxxxxx xxxxxxxx xx compensation xxx xxxx (xxxx xxx xxxxxxxx, xxxxxxxx xxx.) xx xxx xxxxxxx xx xxx Ministry xx Justice xx xx xxx xxxxxx xx xxx xxxxxxx xxxxxxxx. Xxxx xxxxxxxxxx xxxx xxx xxxxx xx xx/xxx xxx xxx xxxxxxxx xxx xxxxxxxxxxxx. If so xxxxxxxxx xx xxx xxxxxx xx xx xxxxxxxxxxx, xxx Xxxxxxxx xx Xxxxxxx xxx xxxxx xxx state's xxxxx to xxxxx xxx return xx xxx xxxxxxxxx support xxxxxxxx after xxx xxxxx of xxx xxxx-xxxx term, provided xxxx x waiver xx xxxxxxxxx xx xxx victim's xxxxxx xxxxxxxx, xxx xxxxx xxxxxx xx xxx xxxx suffered xxx xxx amount xx xxxxxxxxxxxx xxxx xx xxx victim.

Xxxxxx xxx/xxxx/xxxxxx

Xxxxxxxxxxxxxxx xx, že x xxxxxxxx, v xxxxxx xx xxxxxxxxxx, sme xxxxxx Xxx obťažovať xxxxxxxxxxxx xxxxxxxx. V xxxxxx rýchleho posúdenia Xxxxx xxxxxxxx x xxxxxxxxxxx xxxxxxxx pomoci xxxxxxx xxxxxxxx xxxxxxxx xxxľx zákona č. 209/1997 Zb., xx však xxxxxxxxx xxxxx xxxxxxxxx xxxxxxxxxx. Xxxxxxxx Xxx za xxxxxxxxxx, xxxxx xx xxxxx xxxxxx.

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X. Prosím, xxxxxxx xxxxxxľxx osobné xxxxx o žiadateľovi - obeti xxxxxxxxx xxxx, xxxxxx xxôxxxxxx xxxx xx xxxxxx, xxxxx xxxxx xxxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx trestného xxxx zomrela:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Xxxxxx xxxxxxxx xxxxxx:

5. Xxxxxxxxxxxxxx xxxxxx (x xxxxxxx, xx sa xxxx od xxxxxx xxxxxxxx xxxxxxxx):

6. Xxxxxxx:

7. X-Xxxx:

8. Xxxxxxxxxx:

XX. Xx xxxxxxxľx xxxxxxxxx xxx xxxxx (zástupca) xx xxxxxxx xxxxxxxxx zastúpenia (xxxx. maloleté dieťa xxxxxx xxxxxxx) alebo xx xxxxxxx xxxxxx x xxxxx xxxx, xxxxxxx xxxxx o xxxxxxxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxxxxxxxxxxx adresa:

Ak xxxxxxx xx xxx osobu, xxxx xx xxxxxxx xxxxxxxxxx, xxxxx xxxxxxxxxx xxxxxxx. Xxxxx x xxxxxxxx xxxxxxxx xxxxx xxxxx xxxx (xxx xxxxxxxx xxxxxxxxx) xxxxx xxxxx xxxxxxx listu (x prípade xxxxxxxxx xxxxxxxxxx) xxxxx inú xxxxxxx xxxxxxx.

XXX. Xx xxxxxxxľ alebo xxxxx xxxxxxxxx po xxxxx, xxxxx x dôsledku xxxxxxxxx činu xxxxxxx, xxxxxxx, prosím, aj xxxxx x xxxxxxx xxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Dátum xxxxxx:

5. Posledné xxxxxxxx:

7. Xxxxxxxxxx:

8. V xxxx xxxxxx bola zomretá xxxxx x dôsledku xxxxxxxxx xxxx k xxxxx xxxxxxxľx (otec, xxxxx, xxxxx xxxxxx x xxxxxxxxx xxxxxxxxxx):

Xx xx xxxxxxxľ osobou xxxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, x xxxxxxxx xx xxxx xxxxxxxx xxxxx xxxxxxxx xxxxx x xxxxxxx, xxxxx dokladajú xxxxxxxxxx, xx xxxxxx xxxxx vyživovala xxxxxxxxx xxxxx xxxxx xxxx xxxxxxxxx ju vyživovať (xx xxxxxx xxxxx - xxxxx xôxxx x rodný xxxx xxxxx rozhodnutie xxxx x vyživovacej povinnosti, xxx manželov takou xxxxxxxx bude xxxxxxx xxxx x xxx.)

XX. Xxxxxx, xx xxxxxxx xxxxxxxx peňažnú xxxxx xxxxxxxxxxxxxxx pošty alebo xxxxxxxx xx xxxxxxx xxxx; x xxxxx xxxxxxx láskavo oznámte xxxxx Xxxxx účtu.

V. Xxxxxx xxxxx, kedy xx xxxx xxxxxxxxx x xxxxx spôsobenej xxxxxxxx činom.

Uveďte dátum xxxxxxxxx xxxxxxxxx činu x xx sa xxxx o xxxxx xxx spôsobenej xxxxxxxxx xx neskôr, uveďte xxxx x xxx (xxxxxxxxx x xxxxxxxxx xxxxxx - xxxxx xxx vystavenia).

VI. Xxxxxxx xxxxx činný v xxxxxxxx xxxxxx (xxxxxxxxx xxxxx, štátne xxxxxxxxxxxxxx, xxx), xxxxx xxxxxxxxx xxxxx konanie o xxxxxxxx xxxx. Uveďte xx xxxxxxx xxxxxx, xxx ktorou prebieha xxxxxxxxxxxx.

Xx xxxx k xxxxxxxxxx xxxxxxxx rozhodnutie xxxxxx xxxxxxx x xxxxxxxx xxxxxx, xxxxx xxxx xxxxxxxxx x xxx, v xxxx xxxxxx xx xxx xxxxxxxx (xxxx. uznesenie x xxxxxxxx xxxxxxxxx xxxxxxxx, xxxx xxxxxxxx, xxxxxxxx - x xxxxxxxxxxxxx), xxxxxxxx xx x xxxxxxxx.

XXX. Uveďte, xxxx spôsobom xxx xxxxxxxxx nárok na xxxxxxx škody od xxxxxxxľx xxxxx xxxx xxxxx, xxxxx zodpovedá xx xxxxx.

Xxxľx xxxxxxxxxxx §8 xxxxxx x. 209/1997 (Xx)., xxxxxxxx xxxxx xx môže xxxxxx xxxxx xx xxxxxxxx x xxxxxxxxxxxxx xx xx, xx xxxx xxxxxxx xxxxxx xxxxxxx xxxxxxxxxxx xx xxxxxxxxxx xxxxxx xx xxxxxxx škody od xxxxxxxľx alebo xxxx xxxxx, ktorá xxxxxxxxx xx xxxxx. Xxxxx xxx xxxxxxxxxxx, ak xxxxxxxľx xxxxxxxxx xxxx xxxxxxxxx.

Xxx XXXX. Vyplňte, xx xxxxxxxľ xx xxxxxxxxxx xx osobe, xxxxx x xôxxxxxx xxxxxxxxx xxxx zomrela.

VIII. Xxxxxx, xx ste xxxxxxx xxxxxx, xxxxx xxľxx podmienky uvedené x §2 xxxx. 2 xxxxxx x. 209/1997 Zb., xxxxxxxx xxľxx xxôx xxľxx xxxxx xxxxxxxxx, xx xx Vám tieto xxxxxxxxxxx xxxxx.

1. Xxxx xxx rodičom, xxxxxxxx xxxxx dieťaťom xxxxx, xxxxx zomrela x xôxxxxxx xxxxxxxxx činu?

2. Xxxx ste s xxxxxx trestného činu xxxx vykonaním xxxxxxxxx xxxx x xxxxxxxxx xxxxxxxxxx?

3. Poskytovala Xxx xxxx xxxxxxxxx xxxx xxxxxx, xx xxxx x xxxx xxxxxxx?

4. Xxľxxxx xxxxx xxxxx xxxxxxxxxxx xxxxxxxxx 1 xx 3? Xxxxxx xxx počet, xx Xxx xx xxxxx.

Xxxľx xxxxxxxxxxx §2 odst. 2 zákona x. 209/1997 Zb. xx xx xxxx xxxxxxxx xxxxx xxxxxxxxx po xxxxx, xxxxx v xôxxxxxx trestného xxxx xxxxxxx, xx je xxxxxxx, xxxxxxxx xxxxx xxxxxxxx zomretého x xxxxxxx x xxxx xxxx smrti x xxx xxxx x xxxxxxxxxx xxxxx osoba, xxxxxx xxxxxx xxxxxxxxxx xxxxx xxx xxxxxxx xxxxxxxxxx výživu.

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Body IX. xx XIV. Xxxxxxx, xx xx žiadateľ xxxx xxxxxx xxxxxxxxx xxxx a xxxx xx xxôxxxxxx xxxx xx zdraví.

IX. Uveďte xxxxx, xxxx xx xxxxxxxx xxxxxxxx, respektíve xxxx sa xxxxxxxx xxxxxxxx xxxxxxxxxxx.

X. Xxxxxxx xxxxx xxxxxxxx xxxxxxxxxxx xx xxxxxx xxxx:

X xxxxxxxx xx xxxx xxxxxxxx xxxxxx xxxxxxxxxxx xx xxxxxx xxxľx xxxxxxxx č. 440/2001 Zb., xxxxx xxxxxxxľ xxxxx xx xxxxxx, xxxxx ho xxxxxxxxx. Xxxxx lekársky xxxxxxx xxxx obsahovať xxxxxx xxxxxxxxxx xxxxxxxxx xxxxxxx a bodové xxxxxxxxxx xxxxxxxx xxxxxxxxxxxxx xxxxxxxxxx. Xxxxxxxxxxx, xx xxx xxxxx zákona č. 209/1997 Zb. xx xxxxxxxxxx xxx xxxxxx xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxxľx xxxxxxxxxxx §6 odst. 2 zákona č. 209/1997 Xx. xxxxxxx xxxxxxxxx' xxxxxxx pomoc, xx xxxxxx ohodnotenie xxxxxxxxx xxxxxxx nedosiahne xxxxxxxx 100 xxxxx.

XX. Xxxxxx, xx xxxxxxx x poskytnutie xxxxxxxx xxxxxx xx xxxxx xxxxxxxxx xxxxxxx 25&xxxx;000.- Xx xxxxx či xxxxxxxx výšku ušlého xxxxxxx x xxxxxxxx xx liečenie.

Podľa ustanovenia §7 odst. 1 xxxx. a) xxxxxx x. 209/1997 Xx. xx xxxxxxx xxxxx xxxxx xxxxxxxxx xxxxxxx xxxxx xx výške xxxxxxxxx xxxx 25&xxxx;000.- Xx, xxxxx vo xxxxx xxxxxxxxxxxxxx xxxxxxxxxxx xxxxxxxx na xxxxxxxx x xxxxxx xxxxxxx. Xx xx rozhodnete xxxxxx x xxxxxxx xxxxx xx výške xxxxxxxxx xxxxxxx, xxxxxxxx xx vyplňovať body XXX. - XIV. xxxxx xxxxxxxxx.

XXX. Xxxxxxx xxxxxxx x liečením xxxxxx:

Xxx x náklady xx lieky, xxxxxxxxxxxx xxxôxxx, xxxxxxx xx xxxxxxxxxxxxx, pribranie cudzej xxxxx na xxxxx x xxxxxxxxxx xx xxxxxxxxxx, zvýšené xxxxxxx xx xxxxxxx, x xxx. xxx podmienkou, xx xxxxx xxxxxxx xxxxxxxxx xxxxxxxxx. Tu xxxxxxx xxxxxxx xx xxxxx doložiť, xxxx xx ne xxxxxxxxxxxx xxxxxxxxxxxxxx nebude xxxx xxxx zreteľ.

XIII. Xxxxxxx xxxxxxxxx xxxxxx xxxxxxxľx xxxx x po xxxxxx xxxx na xxxxxx xxôxxxxxxx xxxxxxxx xxxxx.

X xxxxxxxx xxxxxxxx xxxxxxx, xxxxx xxxxxxxxxx xxxxxxx xxxxxxxxxxx.

X xxxxxxx, xx xxxxxxxľ xx x zamestnaneckom xxxxxx, xôxxx o xxxxxxxxxx xxxxxxxxxxxxľx x xxxxxxxxxx xxxxxxx podľa §351 x xxxx. xxxxxx x. 262/2006 Xx., xxxxxxxx práce, x xxxxx xxxxxxxxxx xxxxxxxxx. Xx xx žiadateľ xxxxxx xxxxxxxxxx xxxxxxxxx xxxxxx, xxxxx listinou xxxx xxxxxxxxx opis xxxxxxxxxx xxxxxxxx priznania. Xx xxxxxxxľ poberá xxxxxxxx xôxxxxxx, xxxxxxxx, xxxxx xôxx dokázať xxxxxxxx xxxxxxxx situáciu, xxxx potvrdenie x xxxxx xxxxxxxxxx xôxxxxxx. X xxxxxxx, xx x xxxxxxxx závažného xôxxxx xxxxxxx xxxxxxx xxxxxxxxx pomery xxxxxxxľx, x krajnom xxxxxxx xx xxxxx xxxxxxxx xxxxxxxxxx x xxxx xxxxxxx vyhlásením.

XIV. Uveďte xxxxx xxxxxxxxxxxx dávok (xxxxxxxxxxx xôxxxxxx) a xxxx, xxxxxx xxx xxxxxxxľ poberá, xx xxxxxxx po xxxxxx xxxx xx xxxxxx, xxôxxxxxxx xxxxxxxx xxxxx.

X xxxxxxxx priložte xxxxxxxxxx xxxxxxxxxxxxľx xxxxx poisťovne x xxxxx nemocenských xxxxx. X xxxxxxx, xx x dôsledku xxxxx xx xxxxxx xxôxxxxxxx xxxxxxxx xxxxx Xxx priznali invalidný xôxxxxxx, xxxxxx x xxxxxxx jeho xxxxx.

Xxxx majetkové pomery xx xxxx, xx xxxxxxxx činom, xxxxxxx xxx xxx(x) xxxxxx, xx xxxx sociálna xxxxxxxx xxxxxxxx. Škodu, xxxxx xx xxxxx xxôxxxxx, xxxxxľ xxxxxx xxxxxxxx.

Xxxxxx vyhlasujem, xx xxxxx na peňažnú xxxxx či obdobný xxxxx xx xxxxxxxxxxx xxxx xxôxxxxxxx xxxxxxxx xxxxx xxx xxxxxxxxxx(x) x žiadnom xxxx xxxxx xxx x Xxxxxx (Xxxxxxxxxx) xxxxxxxxx.

Xxxxxx xx vedomie, že xx podľa xxx. §12 xxxxxx x. 209/1997 Zb., x xxxxxxxxxx xxxxxxxx xxxxxx xxxxxxx xxxxxxxx činnosti x x xxxxx x x xxxxxxxx xxxxxxxxxx xxxxxxx, x xxxxx xxxxxxxxxx xxxxxxxxx, xxxxxx xxxxxxxxx xx xxxxxxx xxxxx odo xxx, xxx xx xxxxxxxx xxxxx, xxxxxxx xx xxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx čiastky, ktoré xxx xxxxxx(x) xxx xxxxxxx xxxxx, a xx xx xx xxxxx poskytnutej xxxxxx. Xxxxxxx x xxx xxxxxx xx xxxxxxx, xx xx xxxxxxxx xxxxxxxxxx xäxxxxxxx xxxx xôxxx požiadať Ministerstvo xxxxxxxxxxxxxx, aby sa x mene štátu xxxxxx práva xx xxxxxxxx xxxxxxxxxxx xxxxxx, xx xxxx xxxxxxxx xxxxxxxx xxxx xxxx xxxxxx xxôxxxxxxxx, xxxxxxx xxxxx škody, ktorú xx xxôxxxxxx x xxxxx xxxxxxx, xxxxx xxx xxxxxx(x).

Xxxxxx xxxx xx xxxxxxx, že xxxxxxxxx xxxxxxxx nesprávneho xxxxx xxxxxxxxx údaja xx xxxx xxxxxxxxx xx xxxxxx získania xxxxxxxxxxxx xxxxxx, xx xôxxx xxxxxxxx xxxxxxxxxx xxxľx §21 xxxx. 1 xxxx. x) xxxxxx x. 200/1990 Xx., o priestupkoch, x xxxxx xxxxxxxxxx xxxxxxxxx.

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xxxxxx xxxxxxxľx xxxxx xxxxxxxx

- Xxxxxxxxxxxx spravodlivosti Xxxxx xxxxxxxxx xx xxxxxxx xxxxxxxx x xxxxxxxxxxx peňažnej pomoci xxxľx xxxxxx č. 209/1997 Zb. xxxxxxx xxx xxxxxx x xxxxx xxxxxxxx xxxxx. Potom xxxx xxxxxxxxxx xx xxxxxxx xx xx inom xxxxxxxx orgáne xxxľx xxxxxxxxxxx xxxxxxxxx prípadu. Xx troch mesiacov xx xxxxxx žiadosti x predložení xxxxxxxxxx xxxxxxxx xxx pomoc xxxxxxxx xxxxx xxxxxxxľxxx xxxxxx xôxxxx, prečo xxxxx nemožno xxxxxxxx.

- X xxxxxx zákona č. 209/1997 Zb. xxxx xxxxxxxľ xxxxxxxxxx za obeť xxx x xxxxxxx, xx xx x xôxxxxxx trestného činu xxxx spôsobené xxxxxxxxxx xxxxxxx. Nevyhnutnou, xxx xxxx xxxxxxxxxxxx podmienkou xx xxxxxxxxx xxxxxxxx xxxxxx xxxxx xxxxx xx xxxxx bodového xxxxxxxxxxx bolesti (nie xxxx xxxxxxxx xxxxxxxxxxxxx xxxxxxxxxx) dosahujúceho xxxxx 100 bodov. Xx xxxx xx považuje xx xxxxx pozostalá xx obeti, ktorá x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xx xxxx rodičom, manželom xxxxx xxxxxxxx zomretého x zároveň v xxxx jeho smrti x xxx xxxx x xxxxxxxxxx, xxxxx xxxxx, xxxxxx xxxxxxx xxxxxxxxxx alebo bol xxxxxxx poskytovať výživu.

- Xxxxx č. 209/1997 Zb. x xxxxxxxxxx xxxxxxxxx xxxxxx xxxxxxx trestnej xxxxxxxx xxxxxxxxx xxxxxxxxxxx (xxxxxxxx) xxxx 1 xxxx xxx xxx, xxx xx obeť xxxxxxxxx x škode spôsobenej xxxxxxxx xxxxx. Ak xxxxx xxxx xx xxx xx deň xxxxxxxxx trestného xxxx, xxxx dokazuje xxxxxxx, xxxx sa to xxxxx. Ministerstvo xxxxxxxxxxxxxx xxxôxx xxxxxxxx xxxxxxxxxx x poskytnutie xxxxxxxx xxxxxx, xxxxx xx xxxxxxxx po xxxxxxxx xxxxxxxxxx xxxxxx.

- Pomoc xx xx xxxxxxx xxxxx, xxxxxx v xôxxxxxx xxxxxxxxx činu xxxxxxx xxxxx na xxxxxx, xxxxxxxx v xxxxxxxxx xxxx 25&xxxx;000.- Xx alebo xx xxxxx, xxxxx xxxxxxxxxxx xxxxxxxxxx xxxxxx xx xxxxxxx, xxxxxxxxxx xxxxxxx xxxxxxx x xxxxxxxx, xxxxxxx o xxxxx xxxxxxxx čiastok, ktoré xxxx x xxxxxx xxxxxxx xxxxx xx xxxxxxx; xxxxx xx xxxxxx xxxxx xxxxxx xxxxxxxxxx xxxx 150&xxxx;000.- Xx. Ak obeť - po xxx, xxx xxx xxxxxxxx xxxxx - xxxxxxxx, xx xxx vzniknutá xxxxx xx xxxxxx xxx xx, ktorá xxxx podkladom xx xxxxxxxxxxx xxxxxx, na xxx xxxxxxx v xxxxxx xxxxxxxxxx týmto xxxxxxx jej xxxxx xxxxxxxxx xxxxx opäť, x xx až xx xxxxxxxxxx xxxxx 150&xxxx;000.- Xx; xxxxxx xx prihliadne xx xxxxxxx, xxxxx xx xxxx xxxxxxxxx.

- Fyzickej xxxxx, ktorá xx xxxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx zomrela (xx xxxx xxxxxxx, xxxxxxxx alebo xxxxxxxx xxxxxxxxx x zároveň x xxxx xxxx xxxxx x xxx xxxx x domácnosti, xxxxx xxx zomretý xxxxxxxxxx, xx xxx xxxxxxx poskytovať xxxxxx), xx poskytne xxxxxxx xxxxx x paušálnej xxxx 150 000.- Kč; xxxxx vo xxxxxx xxxxx xxxxxx xxxxxxxxxx xxxx 450 000.- Xx, x ak xx xxxxx xxxxx viac xxx xxx xxxxx, xxxxxxxxxxx čiastka sa xxx každej obeti xxxxxxxxx kráti.

- Zákon č. 209/1997 Zb. nenahradzuje xxxxxxxx xxxxxxxxxxx xxxxxxxxxxxxx xxxxxxxxxxľx xxxxxxxxxx vozidiel, xx xxxxx nadväzuje xxxxxxx xxxxxxx xxxxxxxxx zodpovednosti. Xxxxx je xxxxxxxx x xxxxxxxxxxxxxx dopravných xxxôx xxxxxx subjekt, xxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxxxxx, x xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxx x xxxxxx xxxxxxxxxxx xxxxxxxxx s xxxxxxxxxxxxx xx xxxxxxxxx xxxxxxxxx xxxxxxxxx xx xxxxx xxxxxx xxxxxxxxxxxx xxxxxxxxxxxxxx x xxxxxxxxxxx peňažnej xxxxxx.

- Xxxxxxxxxxx, že xx xxxxxxxxxx xxxxxxxx xxxxxx dostupné xxxxxxx x potvrdenia, na xxxxx xxxxxxxxxx pri xxxxxxxxxxxx položkách. Xx xxx xxxxxxxľ neučiní, xxxxxxxxxxxx xxxxxxxxxxxxxx xxxôxx xxxxxxx žiadosť. Ak xxxxxx xxxxxxxxxx x xxxxxxx ani dodatočne xxxxxx, xxxx xxxxxxxxxx xôxx xxx dôvodom xxxxxxxxxxxxx xxxxxxxx pomoci xxxľx xxxxxx č. 209/1997 Zb. Xx však xxxxxxxxxx xxxxxxx xxxxx novú xxxxxxx.

- Upozorňujeme, že xx bude žiadateľovi xxxxxxxxxx xxxxxxx pomoc, xxxxxxxľ xx do xxxxxxx rokov xxx xxx xxxxxxxxxxx pomoci xxxxxxx xx účet xxxxxxxxxxxx xxxxxxxxxxxxxx xxxx, xxxxx xxxxxx xxx xxxxxxx škody (xx xxxxxxxľx, xxxxxxxxx x xxx.) xx do xxxxx xxxxxxxxxxx pomoci. Xxxx povinnosť nemá, xx xx škodu xxxxxxxxxx. Xx xxxxxxx xxxxxxxx xxxxx sa xxxxxxxxxxxx xxxxxxxxxxxxxx xôxx x xxxx štátu xx xxxxxxxx xxxxxxxxxx xäxxxxxxx doby vzdať xxxxx na xxxxxxxx xxxxxxxxxxx xxxxxxxx xxxxxx. Xx xxxxxx xxxxxx xxôxxxxxxx xxxxxxxx xxxxxxxx xxxxx, xxxxxxx výška xxxxx, ktorú jej xxôxxxxxx, x xxxxx xxxxxxx, xxxxx xxxx xxxxxxx.